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Hugh's MD2 Intersession 2 > Chronic Kidney Disease (core) > Flashcards

Chronic Kidney Disease (core) Flashcards

1
Q

What does dysmorphic RBC in urine indicate?

A

Travel through the osmotic gradients of the kidney

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2
Q

What happens to calcium with CKD?

A

It goes down

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3
Q

How do you screen for CKD?

A

ACR - Albumin to creatinine ratio

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3
Q

How is polycystic kidney disease inherited?

A

Autosomal dominant

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4
Q

What is the BP target for CKD?

A

<130/80

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5
Q

What eGFR is require to avoid dialysis?

A

10-15ml/min/1.73m2

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6
Q

What are the indications for testing for CKD?

A

Smoker

DM

HTN

Obesity

Established cardiovascular disease

FHx

Aboriginal or Torres Strait Islander >30 years

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7
Q

How can you image the kidneys?

A

Renal ultrasound

CT

Nuclear isotope scans

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9
Q

What different techniques are available for measuring GFR?

A
  1. IV inulin - measure serum and urine clearance rates
  2. Inject radiolabelled substance and measure serum clearance rates in kidney with nuclear scans
  3. Use an endogenous substance - creatinine
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10
Q

What happens to PTH in CKD?

A

It goes up

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11
Q

Why does HbA1c change with CKD?

A

Insulin isn’t as well metabolised - HbA1c drops

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12
Q

How is CKD defined?

A

eGFR <60 for >3 months

Evidence of kidney disease >3 months

  • microalbuminea
  • proteinuria
  • glomerular haematuria
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13
Q

Why isn’t serum creatinine a perfect indicator of GFR?

A

GFR can drop 50% before creatinine rises

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14
Q

What happens with phosphate in CKD?

A

It goes up

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15
Q

What is the normal size of the kidney?

A

10-12cm

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16
Q

When might an elevated creatinine be benign?

A

If the person who has a very large muscle mass

17
Q

What determines the speed of decline in GFR?

A

Rate of protein leak

18
Q

How can you manage a patient with CKD?

A

Reduce further progression - BP

Reduce cardiovascular risk factors

Early detection of metabolic complication

Medication adjustment

19
Q

What are some physiological complications of kidney disease?

A

Accumulation of solutes and waste products

Accumulation of acids

Sodium/water imbalance

Anaemia

Ca/PO4/PTH imbalance (CKD mineral bone disorder)

20
Q

What Hb do you aim for in someone with CKD?

A

100-120 g/L

21
Q

How is renal osteodystrophy treated?

A

Phosphate binders

Control hyperparathyroidism with 1,25-OH VitD and Cinacalcet (mimics Ca)

22
Q

What are some symptoms of CKD?

A

General - Fatigue, malaise, fluid overload, nocturia

Cardiovascular - HTN, IHD, Pericarditis, HF

GI - Anorexia, N/V, metalic taste in mouth

Skin - Pruritis

Neurological - Restless legs, peripheral neuropathy, seizures

Ophthalmic - HT changes

23
Q

At what eGFR is it advisible to start dialysis?

A

10ml/min/1.73m2

Hugh's MD2 Intersession 2 (14 decks)

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